The Johns Hopkins MAC emphasizes the multidisciplinary approach to rheumatic disease through an integrated program of research, education and community service. The pilot multi-institutional collaboration between Johns Hopkins University, Universty of Maryland and their affiliate Good Samaritan Hospital has proved increasingly productive and stable. An active research program pursues the genetic, immunologic and epidemiologic mechanisms of rheumatic disease, orthopaedic-rheumatology and new professional roles in health care systems. The biochemistry laboratory is now fully operational, with focus upon prostaglandin(s) synthesis and release. The educational program is multidisciplinary, multi-level and broadly based. A model of continuity of care has been defined with a demonstration Rheumatic Disease (in-patient) Unit companion to the out-patient system of our multiple institutions. Herein we propose to (1) intensify our research activities and develop, through computerization, added capacity for data analysis; (2) extend the interdisciplinary dimensions of our educational/research program and define a rheumatology core curriculum for medical school; (3) expand our community commitment through new professional training opportunities and further definition of the rheumatic disease/disability problems regionally.